This study was conducted to assess the referral patterns to specialist from general practitioners in health center and perceived needs of referred patients for specialist care in health center. The study subjects were 249 patients who visited to health centers and were referred to other medical facilities. The data were obtained from questionnaire survey which was conducted in Kyongjuu-city Health center, Seongju-Gun Health center and Koryong-Gun Health center in Kyongsangbuk-Do, from June 10 to october 17, 1995. The total referral rate was 2.7%. The proportion of patients who wished to be referred to medical specialists was 85.9%, and the proportion of patients referred by general practitioners in health centers was 14.1%. Among the patients who wished to be referred to medical specialists, 45.9% visited directly to health centers, 34.6% visited health centers via local clinics and 19.5% visited health centers to get referral permission only. The reasons for getting referral permission in health centers were easy geographical accessibility(34.6 %), easy to get referral permission in health centers(27.l%), and very difficult to get referral permission in local clinics(l6.4%). Among the diseases of referred patients, diseases of the musculoskeletal system and connective tissue were most prevalent on a whole, but diseases of nervous system and sensory organs were comparatively high among the patients who wished to be referred to medical specialists and infectious and parasitic diseases were comparatively high among the patients referred by general practitioners in health centers. The most favorable medical facility was general hospital including university hospital in both groups of patients who wished to be referred to medical specialist and the patient referred by general practitioners in health centers. Regarding the needs for specialist care in health center, 75.2% patients who wished to be referred to medical specialists and 74.3% of patients referred by general practitioners in health center wanted the specialist care. The most frequently requested speciality is internal medicine(47.1%), and then orthopedics and general surgery. Based on above results, this study revealed that the majority of patients referred from health center wished to be referred to medical specialists at their own will, so, referral system at health center level should be changed. And if specialist care in health center be provided, the medical care by internist could be provided first, and then that of orthopedics and general surgery could be provided. These kinds of medical cares could be covered by local clinicians as a part-time job on a voluntary basis.
Connective Tissue ; General Practitioners ; Gyeongsangbuk-do ; Hospitals, General ; Humans ; Musculoskeletal System ; Nervous System ; Orthopedics ; Parasitic Diseases ; Surveys and Questionnaires ; Referral and Consultation* ; Specialization*

No abstract available.
Humans

Thirty-six cases of paroxysmal supraventricular tachycardia which were observed at the Department of Pediatrics, Seoul National University Hospital from 1976 till October 1982, were analyzed. 1. The sex ratio was 1.8:1, male predominance. Sixteen cases (44.4%) were under 1 year of age and 11 cases (30.6%) were under 4 months of age. 2. Cases without known heart disease were 22(61.6%). Among Known etiology, most frequent one was 7 cases(19.4%) of W-P-W syndrome. 3. The sex ratio of group without known heart disease was 2.1:1, and that of group with known heart disease was 1.3:1. Under 4 months of age, there were more cases without known heart disease(72.7%) and after 4 months of age number of cases with and without known heart disease were similar. 4. Most frequent clinical manifestation was tachydyspnea. hepatomegly, irritability, palipitation, cyanosis and pallor, vomiting, chest pain, edema, abdominal pain, and fever were followed in order of frequency. 5. Congestive heart failure occurred in 22 cases(61%). The incidence was related to the duration of attack of tachycardia, age of patients, and heart rate. The longer the duration of attack and the younger the age of patients and the faster the heart rate, the higher incidence of heart failure was observed. 6. As treatment, vagal reflex stimulation was almost ineffective, and digitalization was effective in most of the cases. Verapamil and electrical cardioversion were tried in small number of cases and proved to be effective. 7. One case (2.8%) expired becase of the supraventricular tachycardia. 8. Eight cases (30.8%) had recurrence. In younger age group, recurrence rate was lower. 9. Digoxin was given in 15 cases for prevention of recurrence and was effective in 12 cases.
Abdominal Pain ; Chest Pain ; Child* ; Cyanosis ; Digoxin ; Edema ; Electric Countershock ; Fever ; Heart ; Heart Diseases ; Heart Failure ; Heart Rate ; Humans ; Incidence ; Infant* ; Male ; Pallor ; Pediatrics ; Recurrence ; Reflex ; Seoul ; Sex Ratio ; Tachycardia ; Tachycardia, Supraventricular* ; Verapamil ; Vomiting

Long term follow-up study was done on 38 cases of anterior fusion for spinal tuberculosis especially about effect of buttress graft. The average follow-up period was 16 months. 14 cases of effective buttress group were appeared' to achieve more rapid bony union and prevent further kyphosis or lateral wedging of the involved vertebral body than inadequate buttress group of 7 cases.
Follow-Up Studies ; Kyphosis ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

This study was carried out to assess medical care expenditure of residents in urban poor area. The study population included 377 family members of 85 households in the poor area of Daemyung 8-Dong, Nam-Gu, Taegu and 442 family members of 96 households in a control area. The data was collected through self-administered q'iestionnaires completed by housewives. The survey was conducted. from , March 1 to May 31; 1992. The mean age was 31. 1 years in the poor area and 37. 1 years in the control area. The average number of households per house was 4.5 in the poor area and 4.5 in the control area. The frequency of medical care utilization per household in a one month period was 4.6 in the poor area and 4.3 in the control area. The average number of days of utilization was 12.9 in the poor area and 12.5 in the control area. The averge monthly income of a househlod in the poor area was 848,600 Won compared to the control area's 1,752,300 Won. The average monthly consumption expenditure of a household in the poor area was 568,800 Won and that in the control area 1,238,400 Won. The average medical care monthly expenditure per household was 34,500 Won in the poor area and 58,400 Won in the control area. The proportion of the medical care expenditure to monthly income and to monthly consumption expenditure was 4.1% and 6.1% respectively in the poor area, and 3.3% and 4.7%, respectively in the control area. The premium of medical insurance was 1.5% in both areas. The proportion of cost for drug was 57.4%, for medical appliance was 1.2%, and for medical treatment was 41.1% in the poor area and in the control area 52.4%, 1.9%, 45.7%, respectively. The highest proportion of medical care expenditures in the poor area was herb clinic utilization (36.9%). while hospital and clinic (37.8%) was the highest proportion in the control area. Mean medical care expenditure per visit was 7,400 Won in the poor area and 12,600 Won in the control area. Mean medical care expinditure per day was 2,800 Won in the poor area and 6.300 Won in the control area.
Daegu ; Family Characteristics ; Health Expenditures* ; Humans ; Insurance

Since the introduction of percutaneous mitral valvotomy(PMV) in 1984, PMV was an effecive alternative to surgical commissurotomy in selected patients with severe mitral stenosis. Also PMV was an excellent palliative strategy in such patients who were high risk for operative management or longterm anticoagulation was not feasible. We performed PMV in a patient with very tight mitral stenosis and severe pulmonary hypertension under the general anesthesia because the patient was anticipated to be uncooperative due to mental problem, who was diagnosed as schizophrenia 16 years ago. Robinol was used for premedication and i.v fentanyl was used for maintenance of anesthesia. Inoue balloon was introduced into the LV and gradual ballooning was performed with favorable results. Total anesthesia time and interval from internal jugular vein puncture to the completion of valvuloplasty were 1 hour 45 min and 40 minutes respectively. Hemodynamic variables were improved immediately after intervention and mitral valve area was increased from 0.5cm2 to 1.3cm2.
Anesthesia ; Anesthesia, General* ; Fentanyl ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; Jugular Veins ; Mitral Valve ; Mitral Valve Stenosis* ; Premedication ; Punctures ; Schizophrenia*

No abstract available.
Myocardial Infarction*

BACKGROUND: The goal of this study was to examine the health behaviors of nurses and provide basic information on health promotion for nurses. MATERIALS AND METHODS: A self-administered questionnaire survey was completed by 340 nurses working at a university hospital in Daegu, Korea from March 6 to March 30, 2006. The questionnaire included demographic characteristics, working environment, health behaviors, self-assessed health status, and the practice of health promotion activities according to the work group(shift group vs. non-shift group). RESULTS: There were significant differences in 'regular diet', 'drinking', 'ordinary health management', 'regular exercise', 'leisure activities', 'rest', and 'feeling of fatigue' between the two groups. The score for the practice of health promotion activities of the non-shift group was 121.9, which was higher than the 115.4 for the shift group. By field of practice of health promotion activities, there were significant differences in 'self-realization' and 'nutrition' between the two groups. CONCLUSION: The shift group did not appear to have enough time to take care of their health. It is therefore important to provide a working environment in which nurses are encouraged to increase their interest and efforts to maintain healthy behaviors. In addition, programs for education and training should be developed to help nurses adopt healthy life styles and enhance their self-esteem.
Daegu ; Education ; Health Behavior* ; Health Promotion ; Korea ; Life Style ; Surveys and Questionnaires

The dithiocarbsmates are commonly used worldwide as an agricultural fungicide because they are inexpensive and known to be highly effective, A 37 year old male farmer visited our department because of skin rashes on the face, neck and both handa for three years. Because the patch test results revealed a strong positive reaction to dithiocarbamates, and the irritant reaction to orthodichlorobenzen and the biopsy specimen taken from the lesion of dorsum of hand showed the findings of allergic contact dermatitis, the diagnosis of allergic contact dermatitis due to dithiocarbamate was made. The skin lesions were cleared after avoicing the causative agent along with consertatve treatment. There was no relapse during the one year follow up period.
Adult ; Biopsy ; Dermatitis, Allergic Contact* ; Diagnosis ; Exanthema ; Follow-Up Studies ; Hand ; Humans ; Male ; Neck ; Patch Tests ; Recurrence ; Skin

The AIDS is a serious health problem worldwide today and also in Korea. Increasing knowledge and modification of behavior by health education is an important goal of human immunodeficiency virus(HIV) prevention strategies. And school health education is an important part of health education. This study was conducted to evaluate the knowledge and attitude about AIDS in teachers and professors in Taegu City and to provide the basic data for school health education. A self-administered questionnaire was given to 1,124 teachers and professors from April to June 1992. Indeed, the majority of the teachers and professors have a lot of knowledges about AIDS, but many of them also have misconceptions. The level of knowledge about AIDS was positively associated with attitude toward infected students. The sources of knowledge about AIDS were mainly TV, newspapers and magazines, but a few of the subjects obtained their knowledge from health education programs. This study suggest., that the reinforcement of health education for the teachers, professors and students be needed to provide the accurate knowledge on AIDS and adequate knowledge sources and materials for school health education on AIDS should be developed.
Daegu* ; Education ; Health Education ; Humans ; Korea ; Periodicals ; Periodicals as Topic ; School Health Services